Presentation on theme: "Pain is generally described as an unpleasant sensation. Pain is the reason for initial contact with any physician For the vast majority of medical problems,"— Presentation transcript:
Pain is generally described as an unpleasant sensation. Pain is the reason for initial contact with any physician For the vast majority of medical problems, e.g., abdominal pain, chest pain, limb pain, low back pain. The goal of therapy is to reduce suffering and increase function, which is the overriding purpose for practicing pain management.
To add complexity, many factors, such as culture, personality, psychosocial stressors, nutritional status, and other disease states, can be involved to influence the degree of perceived pain and to confound understanding of the causal factors of the pain. Pain has been classified by anatomic location, body system, duration, severity, frequency, and etiology.
Pain Classification Systems Categories I II III IV V Traditional Acute Subacute Chronic Biopsychosocial Acute Recurrent acute Cancer related Chronic non malignant Pathogenetic Primary Secondary TX. Effect (chemotherapy, tissue trauma, edema, etc.) ICD-9 Disease process Pain location Secondary Dickerson Neuropathic Inflammatory Long-term IASP Region System Chronology Intensity Etiology
The simplest traditional categorization of pain has been “acute” and “chronic.” Acute pain is usually just a result of the stimulation of a normally functioning pain detection system and serves to allow us to avoid or minimize tissue damage. Chronic pain merely means that pain is perceived over a long period of time, which is often arbitrarily set at 3 to 6 months. acute pain is simple nociceptive pain and chronic pain is a complex mix of pathologies along the neural pathways.
The biopsychosocial model includes four categories: acute, recurrent acute, cancer-related, and chronic non malignant pain. Acute, noxious stimulation of nociceptive pain(detecting something at the pain nerve ending), which may also precede neuropathic pain (hypersensitive transmission pathways), occurs at microscopic pain nerve endings as a signal that something is wrong, physically, chemically, or thermally. The neurotransmitters across synapses and endogenous and exogenous neurotoxic substances are microscopic. The upstream normally functioning peripheral and central neurons are microscopic. neuropathic pain is, by definition, pathology of neurons. Because neurons are microscopic, peripherally or centrally, neuropathic pain can be likewise nothing but a “microscopic” event.
Portenoy proposed that three primary categories of pain be used: nociceptive, neuropathic, and psychogenic. In this system, somatogenic pain is subdivided into two subtypes that contrast with psychogenic pain. psychogenic pain is indicated only in the absence of positive signs. Frequently, pain is classified unidimensionally on the basis of severity (0- to 10-point scale with 0 = no pain and 10 = the worst pain that can be imagined).